Related Experiment Videos
Incidence of the prozone phenomenon in syphilis serology
M M el-Zaatari1, M G Martens, G D Anderson
1Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.
Objective:
To determine the rate of the prozone phenomenon in our patient population.
Methods:
Sera from 4328 patients--3504 females (2065 pregnant, 1439 nonpregnant) and 824 males--were tested for syphilis by the rapid plasma reagin (RPR) test, and then rechecked with serial twofold dilutions of up to 16-fold to detect the prozone phenomenon. Chi-square analysis with Yates correction was used, with P < or = .05 considered significant.
Results:
The total positivity rate in females was 6% (213 patients); 13% (27) of the positive tests were false-positive reactions as confirmed by a negative anti-treponemal antibody test. Only one prozone reaction was detected, in serum from a male subject, but it was not missed on initial screening.
Conclusion:
The rate of prozone phenomenon is very low (95% confidence interval 0-0.4%), and routine serial dilutions are not cost effective.